LII:Radiation Oncology/IMRT/IMRT Overview

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This section is about how intensity-modulated radiation therapy (IMRT) works (in brief) and the history of IMRT. More technical aspects of IMRT should be placed in the section Radiation Oncology:IMRT Technical. Clinical results of IMRT should be placed elsewhere.


Timeline of IMRT

  • 1992 - 1994 - proprietary IMRT development at NOMOS (initially named VISUS Medical Devices, then Cognos*centi, then NOMOS)
  • 1994 - NOMOS PEACOCK system (first patient treated in 1994 at The Methodist Hospital, Houston, TX, USA)
  • 1996 - First IMRT treatment with a conventional linac equipped with a multileaf collimator (MLC)


The introduction of a commercial IMRT system into popular use began with the PEACOCK system produced by the NOMOS Corporation (Pennsylvania, USA). The PEACOCK system consists of the MIMiC, which is a "bolt-on" multileaf collimator, and a dedicated treatment planning system. Treatment with the PEACOCK is described as "serial tomotherapy" in which the treatment is delivered using non-overlapping arcs (thus "tomo" or slice therapy) with couch movement occurring between each arc (thus "serial").


Guidelines for the implementation and quality assurance for IMRT.

  • NCI Guidelines on the Use of IMRT in Clinical Trials:
    • (July 25, 2006) "ATC Guidelines for the use of IMRT" - PDF
    • (Jan 14, 2005) "The National Cancer Institute Guidelines for the Use of Intensity-Modulated Radiation Therapy in Clinical Trials" - PDF
  • Advanced Technology Consortium (ATC):
    • 2004 - PMID 15234063 — "Credentialing of institutions for IMRT in clinical trials." Int J Radiat Oncol Biol Phys. 2004 Jul 15;59(4):1257-9


  • Beavis A W. Is tomotherapy the future of IMRT? The British Journal of Radiology 77 (2004), 285-295. (PMID 15107318)


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